Provider Demographics
NPI:1144651308
Name:GUERRA, LEONOR MARIA (SONOGRAPHER)
Entity type:Individual
Prefix:
First Name:LEONOR
Middle Name:MARIA
Last Name:GUERRA
Suffix:
Gender:F
Credentials:SONOGRAPHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 CASA DEL SOL CIR APT 107
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2502
Mailing Address - Country:US
Mailing Address - Phone:727-687-9503
Mailing Address - Fax:
Practice Address - Street 1:3055 CASA DEL SOL CIR APT 107
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2502
Practice Address - Country:US
Practice Address - Phone:727-687-9503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL292454163WR0006X
FL1677992471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant